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SEMINAR ON OCUSERTS By Keerthi Harika, M.Pharm II- sem Department of pharmaceutics, University college of pharmaceutical sciences, Kakatiya university, WARANGAL-506009. CONTENTS Introduction Anatomy of eye Routes of ocular delivery Absorption of drugs in eye Pre-corneal disposition Trans-corneal penetration Conventional ocular drug delivery systems Criteria for selection of ocular dosage form Ocular controlled drug delivery devices Requirements for success Advantages and disadvantages Classification Preparation of ocular insert Characterization of inserts Packaging How to use Conclusion References INTRODUCTION Ophthalmic drug delivery system is one of the most important, interesting & challenging endeavors facing by the pharmaceutical scientist. Anatomy, physiology & biochemistry of eye render this organ highly impervious to foreign substance. BA following intraocular administration of drops may hardly be 1.2% to the aqueous humor and therefore demands suitable intraocular delivery system to increase the BA to a substantial level. ANATOMY AND PHYSIOLOGY OF EYE Structure of eye can be depicted with three layers 1. Outer layer (Cornea & Sclera) 2. middle layer (Iris-ciliary body & choroid) 3. Inner layer (Retina) Eye is filled with two kinds of fluids 1. Aqueous humor between cornea& iris 2. Vitreous humor between lens & retina ROUTES OF OCULAR DELIVERY Absorption of drugs in eye Moment drug is placed in the lower cul-de-sac of eye, several factors immediately begin to affect the bioavailability of drug. Pre-corneal disposition:Pre-corneal constraints include A. Spillage of drug by over flow B. Dilution of drug by tear turnover C. Naso-lacrimal drainage/ systemic drug absorption D. Conjunctival absorption E. Enzymatic metabolism Trans-corneal penetration:Trans-corneal penetration of drug is mainly affected by A. Physicochemical properties of drug B. Corneal barriers C. Active ion transport systems present at cornea TRANSPORT BARRIERS IN THE EYE Cornea, conjunctiva and sclera form the most significant barriers for drug penetration into the intra-ocular tissues. CONVENTIONAL OCULAR DRUG DELIVERY SYSTEMS Dosage form Advantages Disadvantages Solutions Convenience Loss of drug by drainage, No sustained action Suspensions Best for drugs with slow dissolution Loss of both solution and suspended solid Emulsions Prolonged release of drug from Patient non-compliance, vehicle Blurred vision Ointment Improved drug stability, Increased Sticking to eyelids, poor tissue contact time, Resistant to patient compliance, Blurred nasolacrimal drainage vision, Gels Comfortable, less blurred vision Matted eyelids after use, No than ointment rate control on diffusion Erodible inserts Sophisticated & effective delivery, Patient discomfort, Movement Flexibility in drug type, Need only of system around eye can be introduced into eye and not cause abrasion removed Non-erodible inserts Controlled rate release, Prolonged Patient discomfort, Irritation delivery, Flexibility for type of drug to eye, Patient placement and selected removal CRITERIA FOR SELECTION OF OCULAR DOSAGE FORM Gels Injectables DRUG: Target site Long duration Long accessibility, required duration onset of required response Long duration required Low bioavailability Intermediate cost Some blurring Simple administration Reduced frequent administration ---Requires physician ---- Last alternative surgical application Inserts Ointments Solutions Suspension Soluble or Insoluble solubilizable drug Less potent potent Low bioavailability Low bioavailability Requiring high conc. High cost per dose Low cost Low cost Low cost No blurring Severe blurring Little blurring Little blurring Convenient Convenient Accepted Some extend duration Good control Slight of rate of threatening administration Accepted ----- OCULAR CONTROLLED DRUG DEVICES---OCULAR INSERTS Definition- DELIVERY Sterile preparations, with a solid or semisolid consistency Main objective is to increase contact time between conjunctival tissue and preparation Inserted into the eye and worn under the upper or lower lid Ensures a sustained and controlled release effect Requirements for success- COMFOR T EASE OF HANDL ING REPRODUCI BILITY OF RELEASE KINETICS STERILI TY & STABILI TY EASE OF MFG NONINTERFER ENCE WITH VISION LACK OF TOXICIT Y& EXPULSI ON ADVANTAGES Improves BA Prolonged drug release & better efficacy Over comes side effects of pulsed dosing Accurate dose & better therapy Circumvent the protective barriers like drainage etc LIMITATIONS Ophthalmic inserts resides in their solidity Patient discomfort Movement around eye cause abrasion Inadvertent loss during sleep & while rubbing eye Difficult placement & removal Interference with vision (in elderly) CLASSIFICATION The ocular implants are flexible, oval inserts which consist of a medicated core reservoir prepared out of a hydrogel type of materials. They are classified as follows 1. Insoluble inserts Diffusion controlled ocular inserts Osmotic ocular insets Hydrophilic matrix type ocular inserts (contact lens type) 2. Soluble inserts 3. Bio-erodible inserts 4. Implantable silicone devices 5. Implantable infusion devices Ocufit® &Lacrisert ® Minidisk ocular therapeutic system New ophthalmic delivery systems (NODS®) Insoluble ophthalmic inserts Diffusion controlled ocular inserts These consists of a medicated core prepared out of a hydrogel polymer like alginates, sandwiched between two sheets of transparent lipophilic, rate controlling polymer. The drug molecule penetrate through the rate controlling membranes at zero order rate process. dQ/dt = Dp Km (Cr-Ct)/δm dQ/dt = Dp Km Cs/δm (Cr >> Ct sink condition) eg ; ocusert pilo-20 Osmotic inserts Generally composed of a central part (drug) surrounded by a peripheral part (osmotic solute). Components of osmotic inserts Water permeable Ethylene- vinyl esters copolymers Semi permeable Cellulose acetate derivatives, others- ethyl vinyl acetate, Polyesters of acrylic and methacrylic Acids (Eudragits) Osmotic agents Inorganic- Mg sulfate, Nacl, Pot. Phosphate dibasic, Sod. Carbonate, Sod. Sulphate Organic- ca. lactate, mg. succinate, tartaric acid Carbohydrates- sorbitol, mannitol, glucose, sucrose Generic osmotic mini pump (ALZET) is useful implantable drug delivery system with a const drug delivery rate with a pumping duration of up to 2 weeks. Hydrophilic matrix type ocular inserts (contact lens type) This system is a coherently cross-linked hydrophilic or hydrophobic polymer that forms a 3D- network or matrix, capable of retaining water, Aq. Solution or solid components. Polymers used are 2- hydroxy ethyl methacrylate, vinyl pyrrolidone acrylic co-polymer etc. contact lenses are the only class that have the ability to correct any refractive errors that the patient may have and thereby provide improved visual acuity. Biomedical application in intra-ocular administration of antibiotics, anti glaucoma drugs, anti inflammatory steroids etc. This type of device substantially prolongs the drug /eye contact time and thus increases bioavailability. Soluble ocular inserts Offer great advantage of being entirely soluble. Broadly divided into two types based on natural polymers & semisynthetic polymers. Natural polymersEg., collagen derivatives Chitosan derivatives 1 & 4.Ethylene/ vinyl acetate membrane 2. Tio2 white ring 3. Drug reservoir Synthetic and semi- synthetic polymersOffer additional advantage of simple design & easily processed. Soluble synthetic polymers Cellulose derivatives- HPC, MC, HEC, HPMC, SOD. CMC others- poly vinyl alcohol, ethylene vinyl acetate co polymer Additives Plasticizers- poly ethylene glycol, glycerine, propylene glycol complexing agent- PVP Bioadhesives- poly acrylic acids, methyl hyroxy ethyl cellulose Soluble cellulose derivative inserts are composed of 30% of water. Presence of water is unfavorable from stand point of stability of drug. Insert can be sterilized by exposure to gamma radiation without the cellulose component being altered. The first soluble ophthalmic drug insert (SODI) developed was of soluble co-polymer of acrylamide, N- vinyl pyrrolidone & ethyl acetate. It was in form of sterile thin films or wafers or oval shape, weighing 15 – 16 mg. A new type of ophthalmic insert incorporating a water- soluble bio-adhesive component in its formulation has been developed to decrease risk of expulsion & ensure prolonged residence in eye, combined with the controlled release. These inserts, named bio-adhesive ophthalmic drug inserts (BODI) BIO ERODIBLE INSERTS Main component of this type of inserts is the bio-erodible polymers. They undergoes hydrolysis of chemical bonds & hence dissolution. Bio-erodible matrix controlling the release rate of the drug ensures zero order release rate. Eg., poly (ortho esters), poly (ortho carbonates) Great advantage of these bio-erodible polymers is the possibility of modulating their erosion rate by modifying their final structure during synthesis. Implantable silicone devices Developed for the local delivery of an anti-neoplastic drug to the intra-ocular site. Composed of 2 sheets of silicone rubber glued to the edge with adhesive to form a balloon like sac through which a silicone tubing (0.3 mm dia) is inserted. Such devices have significant potential for local controlled delivery of anti- bacterial, anti-cancer, & anti-viral drugs to anterior chamber of eye. Implantable infusion devices In this device, the canalicular system is intubsted with fenestrated silastic tubing. It is subcutaneously tunneled & then attached to a miniaturized & computerized pumping device, which is capable of pumping a predetermined volume of solution continuously. Intra- ocular drug delivery pumping device is Infusaid® . Here the energy for pumping is met by an expanding fluid like a fluorocarbon in gas- liquid equilibrium at body temperature. Other delivery devices Ocufit® is a sustained release rod shape device made up of silicone elastomer. Lacrisert® is another cylindrical device, which is made of HPC and used for treating dry- eye patients. Mini disk ocular therapeutic systems (OTS)- It is a miniature contact lens shaped, made of silicone based pre polymer. It requires less time & less manual dexterity for insertion, when compared with lacrisert®. New ophthalmic delivery system (NODS)- It is a method for delivering precise amounts of drugs to eye within a water soluble, drug- loaded film. When evaluated in humans, the NODS produced an 8 fold increase in BA for pilocarpine with respect to std. eye drop formulations. Preparation of ocular insert Casting method Polymer solution of diff composition were prepared in boiling distilled water Kept aside for 20-24 hrs to get clear solution & then 10% w/w plasticizer was added & stirred for 3 hrs Weighed amounts of drug was added & stirred for 4hrs to get uniform dispersion Dispersion was degassed & casted on glass substrate & dried at 500c for 18-20 hrs Dried films are carefully removed & inserts of required dimensions were punched out, wrapped individually in Al. foil Characterization of inserts Uniformities of weight & thickness Uniformities of drug content Surface PH In-vitro release studies (continuous flow through apparatus) Ocular irritation test In-vitro microbial studies PACKAGING Ophthalmic insert 5 mg supplied in packages of 60 sterile unit dosage forms. Each wrapped in an aluminum blister. With two reusable applicators. A plastic storage container to store the applicators for use. How To Use •To apply the system, wash hands first. •Tilt your head back, gaze upward and pull down the lower eyelid to make a pouch. •Place the system into the pouch. •Blink a few times and roll your eye to move the insert into place. •Practice inserting and removing the system in the doctor s office where you can be shown the proper technique. •Damaged or deformed systems should not be used or kept in the eye. •Replace with a new system. Conclusion Solution or suspension drops and ointments still remain the first line approach to treatment in standard therapies. However, in circumstances demanding less frequent dosing, or dosing into less accessible compartments of the eye, more unique approaches are indicated. Small, ocular solid dosage forms, in particular gel-forming erodible inserts, show interesting in vivo performances and allow for therapeutic levels to be obtained over an extended period of time in the tear film and anterior chamber. Mucoadhesive inserts are promising ocular drug delivery systems to treat external and intraocular eye infections, and diseases that require frequent eye drops instillation in order to maintain therapeutic drug levels. Successful development of these novel formulations will obviously require assimilation of a great deal of emerging information about the chemical nature and physical structure of new polymeric materials. However the attempts based on these principles are surely a route to better drug Bioavailability through the stubborn sites (as eye) for drug delivery. REFERENCES 1. Novel drug delivery systems II edition ,revised and expanded y.w.Chien. Page no:255 2. Controlled drug delivery fundamentals and applications II edition joseph R. Robinson., vincent H.L.Lee. page no 55. 3. S.P.Vyas & Roop.K.Khar , Controlled release of Drug Delivery concepts and advances. 4. Advances in controlled and novel drug delivery ; edited by N.K.Jain 5. Ocular Transporters in Ophthalmic Diseases and Drug Delivery; Edited by Joyce Tombran-Tink, Colin J. Barnstable. 6. Encyclopedia of Pharmaceutical Technology ;Third Edition edited by James Swarbrick; volume- II 7. Ophthalmic Drug Delivery Systems Second Edition, Revised and Expanded; edited by Ashim K. Mitra; MARCEL DEKKER, INC 8. Enhancement in Drug Delivery; Edited by Elka Touitou, Brian W. Barry 9. Modern Pharmaceutics Fourth Edition, Revised and Expanded; edited by Gilbert S. Banker, Christopher T. Rhodes; Marcel Dekker,Inc. 10. www. Wikipedia.com 11. www.scribd.com 12. www.authorstream.com THANK U “ Sight is the sense which is more valuable than all the rest” So Take Care Of Eyes!!!!!!